Texas 2023 - 88th Regular

Texas Senate Bill SB14 Compare Versions

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Version 2 (New)

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1	1	S.B. No. 14
2	2
3	3
4	4	AN ACT
5	5	relating to prohibitions on the provision to certain children of
6	6	procedures and treatments for gender transitioning, gender
7	7	reassignment, or gender dysphoria and on the use of public money or
8	8	public assistance to provide those procedures and treatments.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 62.151, Health and Safety Code, is
11	11	amended by adding Subsection (g) to read as follows:
12	12	(g) The child health plan may not provide coverage for
13	13	services prohibited by Section 161.702 that are intended to
14	14	transition a child's biological sex as determined by the child's sex
15	15	organs, chromosomes, and endogenous profiles.
16	16	SECTION 2. Chapter 161, Health and Safety Code, is amended
17	17	by adding Subchapter X to read as follows:
18	18	SUBCHAPTER X. GENDER TRANSITIONING AND GENDER REASSIGNMENT
19	19	PROCEDURES AND TREATMENTS FOR CERTAIN CHILDREN
20	20	Sec. 161.701. DEFINITIONS. In this subchapter:
21	21	(1) "Child" means an individual who is younger than 18
22	22	years of age.
23	23	(2) "Health care provider" means a person other than a
24	24	physician who is licensed, certified, or otherwise authorized by
25	25	this state's laws to provide or render health care or to dispense or
26	26	prescribe a prescription drug in the ordinary course of business or
27	27	practice of a profession.
28	28	(3) "Medicaid" means the medical assistance program
29	29	established under Chapter 32, Human Resources Code.
30	30	(4) "Physician" means a person licensed to practice
31	31	medicine in this state.
32	32	Sec. 161.702. PROHIBITED PROVISION OF GENDER TRANSITIONING
33	33	OR GENDER REASSIGNMENT PROCEDURES AND TREATMENTS TO CERTAIN
34	34	CHILDREN. For the purpose of transitioning a child's biological
35	35	sex as determined by the sex organs, chromosomes, and endogenous
36	36	profiles of the child or affirming the child's perception of the
37	37	child's sex if that perception is inconsistent with the child's
38	38	biological sex, a physician or health care provider may not
39	39	knowingly:
40	40	(1) perform a surgery that sterilizes the child,
41	41	including:
42	42	(A) castration;
43	43	(B) vasectomy;
44	44	(C) hysterectomy;
45	45	(D) oophorectomy;
46	46	(E) metoidioplasty;
47	47	(F) orchiectomy;
48	48	(G) penectomy;
49	49	(H) phalloplasty; and
50	50	(I) vaginoplasty;
51	51	(2) perform a mastectomy;
52	52	(3) provide, prescribe, administer, or dispense any of
53	53	the following prescription drugs that induce transient or permanent
54	54	infertility:
55	55	(A) puberty suppression or blocking prescription
56	56	drugs to stop or delay normal puberty;
57	57	(B) supraphysiologic doses of testosterone to
58	58	females; or
59	59	(C) supraphysiologic doses of estrogen to males;
60	60	or
61	61	(4) remove any otherwise healthy or non-diseased body
62	62	part or tissue.
63	63	Sec. 161.703. EXCEPTIONS. (a) Section 161.702 does not
64	64	apply to the provision by a physician or health care provider, with
65	65	the consent of the child's parent or legal guardian, of:
66	66	(1) puberty suppression or blocking prescription
67	67	drugs for the purpose of normalizing puberty for a minor
68	68	experiencing precocious puberty; or
69	69	(2) appropriate and medically necessary procedures or
70	70	treatments to a child who:
71	71	(A) is born with a medically verifiable genetic
72	72	disorder of sex development, including:
73	73	(i) 46,XX chromosomes with virilization;
74	74	(ii) 46,XY chromosomes with
75	75	undervirilization; or
76	76	(iii) both ovarian and testicular tissue;
77	77	or
78	78	(B) does not have the normal sex chromosome
79	79	structure for male or female as determined by a physician through
80	80	genetic testing.
81	81	(b) Section 161.702 does not apply to the provision of a
82	82	prescription drug to a child that is otherwise prohibited by that
83	83	section if:
84	84	(1) the prescription drug is part of a continuing
85	85	course of treatment that the child began before June 1, 2023; and
86	86	(2) the child attended 12 or more sessions of mental
87	87	health counseling or psychotherapy during a period of at least six
88	88	months before the date the course of treatment described by
89	89	Subdivision (1) began.
90	90	(c) A child to whom the exception under Subsection (b)
91	91	applies:
92	92	(1) shall wean off the prescription drug over a period
93	93	of time and in a manner that is safe and medically appropriate and
94	94	that minimizes the risk of complications; and
95	95	(2) may not switch to or begin a course of treatment on
96	96	another prescription drug that a physician or health care provider
97	97	is prohibited from providing to the child under Section 161.702 or
98	98	otherwise receive a procedure or treatment prohibited by that
99	99	section.
100	100	Sec. 161.704. PROHIBITED USE OF PUBLIC MONEY. Public money
101	101	may not directly or indirectly be used, granted, paid, or
102	102	distributed to any health care provider, medical school, hospital,
103	103	physician, or any other entity, organization, or individual that
104	104	provides or facilitates the provision of a procedure or treatment
105	105	to a child that is prohibited under Section 161.702.
106	106	Sec. 161.705. PROHIBITED STATE HEALTH PLAN REIMBURSEMENT.
107	107	The commission may not provide Medicaid reimbursement and the child
108	108	health plan program established by Chapter 62 may not provide
109	109	reimbursement to a physician or health care provider for provision
110	110	of a procedure or treatment to a child that is prohibited under
111	111	Section 161.702.
112	112	Sec. 161.706. ATTORNEY GENERAL ENFORCEMENT. (a) If the
113	113	attorney general has reason to believe that a person is committing,
114	114	has committed, or is about to commit a violation of Section 161.702,
115	115	the attorney general may bring an action to enforce this subchapter
116	116	to restrain or enjoin the person from committing, continuing to
117	117	commit, or repeating the violation.
118	118	(b) Venue for an action brought under this section is in a
119	119	district court of Travis County or the county where the violation
120	120	occurred or is about to occur.
121	121	SECTION 3. Section 32.024, Human Resources Code, is amended
122	122	by adding Subsection (pp) to read as follows:
123	123	(pp) The medical assistance program may not provide
124	124	coverage for services prohibited by Section 161.702, Health and
125	125	Safety Code, that are intended to transition a child's biological
126	126	sex as determined by the child's sex organs, chromosomes, and
127	127	endogenous profiles.
128	128	SECTION 4. Section 164.052(a), Occupations Code, is amended
129	129	to read as follows:
130	130	(a) A physician or an applicant for a license to practice
131	131	medicine commits a prohibited practice if that person:
132	132	(1) submits to the board a false or misleading
133	133	statement, document, or certificate in an application for a
134	134	license;
135	135	(2) presents to the board a license, certificate, or
136	136	diploma that was illegally or fraudulently obtained;
137	137	(3) commits fraud or deception in taking or passing an
138	138	examination;
139	139	(4) uses alcohol or drugs in an intemperate manner
140	140	that, in the board's opinion, could endanger a patient's life;
141	141	(5) commits unprofessional or dishonorable conduct
142	142	that is likely to deceive or defraud the public, as provided by
143	143	Section 164.053, or injure the public;
144	144	(6) uses an advertising statement that is false,
145	145	misleading, or deceptive;
146	146	(7) advertises professional superiority or the
147	147	performance of professional service in a superior manner if that
148	148	advertising is not readily subject to verification;
149	149	(8) purchases, sells, barters, or uses, or offers to
150	150	purchase, sell, barter, or use, a medical degree, license,
151	151	certificate, or diploma, or a transcript of a license, certificate,
152	152	or diploma in or incident to an application to the board for a
153	153	license to practice medicine;
154	154	(9) alters, with fraudulent intent, a medical license,
155	155	certificate, or diploma, or a transcript of a medical license,
156	156	certificate, or diploma;
157	157	(10) uses a medical license, certificate, or diploma,
158	158	or a transcript of a medical license, certificate, or diploma that
159	159	has been:
160	160	(A) fraudulently purchased or issued;
161	161	(B) counterfeited; or
162	162	(C) materially altered;
163	163	(11) impersonates or acts as proxy for another person
164	164	in an examination required by this subtitle for a medical license;
165	165	(12) engages in conduct that subverts or attempts to
166	166	subvert an examination process required by this subtitle for a
167	167	medical license;
168	168	(13) impersonates a physician or permits another to
169	169	use the person's license or certificate to practice medicine in
170	170	this state;
171	171	(14) directly or indirectly employs a person whose
172	172	license to practice medicine has been suspended, canceled, or
173	173	revoked;
174	174	(15) associates in the practice of medicine with a
175	175	person:
176	176	(A) whose license to practice medicine has been
177	177	suspended, canceled, or revoked; or
178	178	(B) who has been convicted of the unlawful
179	179	practice of medicine in this state or elsewhere;
180	180	(16) performs or procures a criminal abortion, aids or
181	181	abets in the procuring of a criminal abortion, attempts to perform
182	182	or procure a criminal abortion, or attempts to aid or abet the
183	183	performance or procurement of a criminal abortion;
184	184	(17) directly or indirectly aids or abets the practice
185	185	of medicine by a person, partnership, association, or corporation
186	186	that is not licensed to practice medicine by the board;
187	187	(18) performs an abortion on a woman who is pregnant
188	188	with a viable unborn child during the third trimester of the
189	189	pregnancy unless:
190	190	(A) the abortion is necessary to prevent the
191	191	death of the woman;
192	192	(B) the viable unborn child has a severe,
193	193	irreversible brain impairment; or
194	194	(C) the woman is diagnosed with a significant
195	195	likelihood of suffering imminent severe, irreversible brain damage
196	196	or imminent severe, irreversible paralysis;
197	197	(19) performs an abortion on an unemancipated minor
198	198	without the written consent of the child's parent, managing
199	199	conservator, or legal guardian or without a court order, as
200	200	provided by Section 33.003 or 33.004, Family Code, unless the
201	201	abortion is necessary due to a medical emergency, as defined by
202	202	Section 171.002, Health and Safety Code;
203	203	(20) otherwise performs an abortion on an
204	204	unemancipated minor in violation of Chapter 33, Family Code;
205	205	(21) performs or induces or attempts to perform or
206	206	induce an abortion in violation of Subchapter C, F, or G, Chapter
207	207	171, Health and Safety Code;
208	208	(22) in complying with the procedures outlined in
209	209	Sections 166.045 and 166.046, Health and Safety Code, wilfully
210	210	fails to make a reasonable effort to transfer a patient to a
211	211	physician who is willing to comply with a directive; [or]
212	212	(23) performs or delegates to another individual the
213	213	performance of a pelvic examination on an anesthetized or
214	214	unconscious patient in violation of Section 167A.002, Health and
215	215	Safety Code; or
216	216	(24) performs a gender transitioning or gender
217	217	reassignment procedure or treatment in violation of Section
218	218	161.702, Health and Safety Code.
219	219	SECTION 5. Subchapter B, Chapter 164, Occupations Code, is
220	220	amended by adding Section 164.0552 to read as follows:
221	221	Sec. 164.0552. PROHIBITED ACTS REGARDING GENDER
222	222	TRANSITIONING OR GENDER REASSIGNMENT PROCEDURES AND TREATMENTS ON
223	223	CERTAIN CHILDREN. (a) The board shall revoke the license or other
224	224	authorization to practice medicine of a physician who violates
225	225	Section 161.702, Health and Safety Code. The board shall refuse to
226	226	admit to examination or refuse to issue a license or renewal license
227	227	to a person who violates that section.
228	228	(b) The sanctions provided by Subsection (a) are in addition
229	229	to any other grounds for revocation of a license or other
230	230	authorization to practice medicine or for refusal to admit persons
231	231	to examination under this subtitle or to issue a license or renew a
232	232	license to practice medicine under this subtitle.
233	233	SECTION 6. Section 164.052, Occupations Code, as amended by
234	234	this Act, and Section 164.0552, Occupations Code, as added by this
235	235	Act, apply only to conduct that occurs on or after the effective
236	236	date of this Act. Conduct that occurs before the effective date of
237	237	this Act is governed by the law in effect on the date the conduct
238	238	occurred, and the former law is continued in effect for that
239	239	purpose.
240	240	SECTION 7. If before implementing any provision of this Act
241	241	a state agency determines that a waiver or authorization from a
242	242	federal agency is necessary for implementation of that provision,
243	243	the agency affected by the provision shall request the waiver or
244	244	authorization and may delay implementing that provision until the
245	245	waiver or authorization is granted.
246	246	SECTION 8. If any provision of this Act or its application
247	247	to any person or circumstance is held invalid, the invalidity does
248	248	not affect other provisions or applications of this Act that can be
249	249	given effect without the invalid provision or application, and to
250	250	this end the provisions of this Act are declared to be severable.
251	251	SECTION 9. This Act takes effect September 1, 2023.
252	252	______________________________ ______________________________
253	253	President of the Senate Speaker of the House
254	254	I hereby certify that S.B. No. 14 passed the Senate on
255	255	April 4, 2023, by the following vote: Yeas 19, Nays 12; and that
256	256	the Senate concurred in House amendments on May 17, 2023, by the
257	257	following vote: Yeas 19, Nays 12.
258	258	______________________________
259	259	Secretary of the Senate
260	260	I hereby certify that S.B. No. 14 passed the House, with
261	261	amendments, on May 15, 2023, by the following vote: Yeas 87,
262	262	Nays 56, two present not voting.
263	263	______________________________
264	264	Chief Clerk of the House
265	265	Approved:
266	266	______________________________
267	267	Date
268	268	______________________________
269	269	Governor